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The Critical Role of State Health Depts. in the U.S. Fungal Meningitis Outbreak: 4 Key Efforts

CDC remains at the front line of the current U.S. fungal meningitis outbreak, which has since early October sickened 490 people and caused 34 deaths in 19 states. On Nov. 15, the U.S. Senate Committee on Health, Education, Labor, and Pensions held a hearing about this outbreak. This post is an excerpt from the testimony of Dr. Beth Bell, director of the National Center for Emerging and Zoonotic Infectious Diseases at CDC, who discussed, among other things, the critical role state health departments played in detecting and sounding the alarm on this outbreak of fungal meningitis and other infections.

More than 70 percent of CDC’s funding supports state and local health departments, non-government partners, and other organizations. CDC also supports health departments with training and guidance to build nationwide lab capacity for detecting and responding to health threats like fungal meningitis. CDC also connects health departments across the United States, helping recognize disease patterns and making state responses to health problems more effective.

The Words of Dr. Beth Bell:

CDC works 24-7 to save lives and protect people from harm. The current U.S. fungal meningitis outbreak illustrates the power of public health in action to identify serious health problems and coordinate a targeted response that protects our nation and its citizens from infectious disease threats.

CDC and our partners at state and local health departments marshaled an enormous effort nationwide to determine the source and scope of the outbreak, rapidly contact patients at risk, and enlist the individual input of leading experts to help us develop novel diagnostic and treatment guidance to achieve the best possible patient outcomes.

In this outbreak, local infectious disease officials, including state epidemiologists, healthcare associated infection prevention coordinators, and others whose positions are directly supported through CDC’s Epidemiology and Laboratory Capacity cooperative agreement and CDC’s Emerging Infections Program were pivotal in the original identification of the outbreak and the substantial patient notification that followed. Their efforts at the state and local level have been extraordinary and in many cases undoubtedly contributed directly to saving the lives of exposed patients.

The Tennessee Department of Health (TN DOH) identified and sounded the alarm on the initial cluster of cases.The TN DOH official who alerted others about these cases serves as the state’s Healthcare-Associated Infections Program director and is a graduate of CDC’s Epidemic Intelligence Service program. Tennessee also is one of CDC’s 10 Emerging Infections Program sites and as such receives additional resources that helped support their response in this outbreak.

The Virginia Department of Health and Virginia’s sate public health laboratory (DCLS), whose staff had been trained by CDC in identifying fungi, were the first to identify the very rare fungal pathogen, Exserohilum. This discovery saved valuable time and provided the nation with a critical piece of information to guide diagnostic and treatment recommendations.

More than 250 Federal disease control specialists have been working out of CDC’s Emergency Operations Centerto coordinate the multistate fungal outbreak response efforts with Federal, state, local, tribal, and territorial public health partners. CDC coordination was helpful to ensure patient notification, development and dissemination of treatment guidance, and rapid communication to the public and the health professions community. (Photo: Dr. Benjamin Park, EOC surveillance team lead, updates the incident manager and colleagues on CDC activities in response to the outbreak.)

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